Fentanyl Billionaire Denies Paying Kickbacks

November 19, 2017 | Opioid Crisis

Opioid multimillionaire John Kapoor pleaded not guilty to charges of racketeering, conspiracy, mail fraud, and wire fraud in an Arizona federal court; prosecutors claim that Mr. Kapoor’s company — Insys Therapeutics — gave doctors millions of dollars in kickbacks if they prescribed one of the company’s prescription pain pills.

Mr. Kapoor became a billionaire in 2013 due to incredibly strong sales of Subsys, which is fentanyl that’s sprayed under the tongue. The Food and Drug Administration approved the drug for cancer patients suffering from debilitating pain. But according to court documents, company officials, including Mr. Kapoor, funneled money and favors to nurses and doctors so they would write Subsys prescriptions to as many patients as possible, most of whom did not even have cancer. Mr. Kapoor, although no longer a board member, still owns more than two-thirds of the company he helped found. Six other current and former company executives face similar charges; they have all pleaded not guilty.

Mr. Karpoor, who also controls most of generic drug giant Akorn, confidently announced that “I have committed no crimes and believe I will be fully vindicated after trial.”

Opioid Pain Relievers

Somewhat ironically, authorities took Mr. Karpoor into custody on the same day that President Donald Trump declared opioid addiction to be a national emergency, mostly because of pain relievers like fentanyl. In 2016, singer Prince Nelson died from a fentanyl overdose, as the substance is up to 100 times stronger than morphine. Sprayable fentanyl is even more powerful than the slow-release fentanyl patch, which may be addictive even if used as properly prescribed.

Over-prescribing pain medication significantly increases the chances of addiction, since these patients only feel the high. Doctors have a duty to prescribe pain medication that is both safe to use and not overly strong. Furthermore, since patients trust their doctors to make decisions that are in their best interests, the duty is one of the strongest ones that the law recognizes.

The Prescription Drug Process

Drug companies incur significant costs to get a drug approved. These expenses have increased nearly 150 percent over the past several years and now exceed an average of $2.5 billion. To recoup these substantial costs, and also show a healthy profit, companies like Insys Therapeutics face intense pressure to sell as much product as possible, as quickly as possible.

Even if the FDA says that a new drug is safe for only limited purposes, it usually approves the drug with no strings attached, opening the door for drug makers to expand sales in any way possible. One common method, as outlined in the allegations detailed above, is to give practitioners a financial or other incentive to prescribe the drug off-label in experimental situations.

Such illegal behavior gives victim/plaintiffs an opening to base their damage claims on the negligence per se rule.

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